Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 25MA08762100 | NJ |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 265211 | NY |
NPI | 1942529367 |
---|---|
Provider Name | Dr. Emil L Gurshumov |
First Address | Brooklyn, NY 11235-3020 |
Second Address | Brooklyn, NY 11235-3020 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2010 |
Last Update Date | 09/08/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03624004 | (05) | NY |